Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $118.59 / $155.65 / $259.35	Facility	26	$118.59	$155.65	$259.35
Aetna Facility/Professional Professional Modifier Low / Median / High Price $351.80 / $500.53 / $965.31	Professional		$351.80	$500.53	$965.31
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $85.72 / $140.00 / $188.02	Professional	26	$85.72	$140.00	$188.02
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $259.35 / $362.88 / $800.46	Professional	TC	$259.35	$362.88	$800.46
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $327.61 / $418.94 / $692.63	Professional		$327.61	$418.94	$692.63
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $77.44 / $96.41 / $148.99	Professional	26	$77.44	$96.41	$148.99
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $250.16 / $319.89 / $532.51	Professional	TC	$250.16	$319.89	$532.51
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $617.73 / $629.50 / $2,950.39	Professional		$617.73	$629.50	$2,950.39
CareFirst Facility/Professional Professional Modifier 26 Low / Median / High Price $93.81 / $101.01 / $124.57	Professional	26	$93.81	$101.01	$124.57
CareFirst Facility/Professional Professional Modifier TC Low / Median / High Price $516.72 / $532.01 / $838.28	Professional	TC	$516.72	$532.01	$838.28
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $97.25 / $97.25	Facility	26	$97.25	$97.25	$97.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $325.75 / $867.95 / $1,404.88	Professional		$325.75	$867.95	$1,404.88
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $68.87 / $111.96 / $207.54	Professional	26	$68.87	$111.96	$207.54
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $254.26 / $664.91 / $1,191.00	Professional	TC	$254.26	$664.91	$1,191.00
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $338.02 / $405.62 / $497.09	Professional		$338.02	$405.62	$497.09
Kaiser Permanente Facility/Professional Professional Modifier 26 Low / Median / High Price $76.19 / $94.11 / $114.38	Professional	26	$76.19	$94.11	$114.38
Kaiser Permanente Facility/Professional Professional Modifier TC Low / Median / High Price $261.83 / $314.20 / $385.05	Professional	TC	$261.83	$314.20	$385.05
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $128.31 / $149.00 / $266.31	Facility	26	$128.31	$149.00	$266.31
Medcost Facility/Professional Professional Modifier Low / Median / High Price $118.13 / $663.20 / $1,385.00	Professional		$118.13	$663.20	$1,385.00
Sentara Facility/Professional Professional Modifier Low / Median / High Price $120.47 / $636.69 / $1,183.38	Professional		$120.47	$636.69	$1,183.38
Sentara Facility/Professional Professional Modifier 26 Low / Median / High Price $90.98 / $121.14 / $191.82	Professional	26	$90.98	$121.14	$191.82
Sentara Facility/Professional Professional Modifier TC Low / Median / High Price $300.61 / $558.83 / $828.56	Professional	TC	$300.61	$558.83	$828.56
United Facility/Professional Professional Modifier Low / Median / High Price $314.02 / $597.32 / $1,298.78	Professional		$314.02	$597.32	$1,298.78
United Facility/Professional Professional Modifier 26 Low / Median / High Price $64.80 / $108.10 / $166.69	Professional	26	$64.80	$108.10	$166.69
United Facility/Professional Professional Modifier TC Low / Median / High Price $240.54 / $475.81 / $1,158.90	Professional	TC	$240.54	$475.81	$1,158.90